Legal Guardianship Forms Arizona Details

As a parent, you may be faced with a situation where you are unable to care for your child and need someone else to take guardianship of them. This can be a difficult decision, but if it is the best thing for your child, you will need to take steps to make sure their welfare is protected. The first step in this process is completing the Guardianship of Minors Arizona form. This document will provide the court with all the information they need to determine who should be responsible for your child's care. It is important to complete this form accurately and fully so that there are no delays in getting your child the help they need.

You'll discover info about the type of form you wish to submit in the table. It can show you the length of time you will need to complete guardianship of minors arizona, what fields you need to fill in, and so on.

QuestionAnswer
Form NameGuardianship Of Minors Arizona
Form Length19 pages
Fillable?No
Fillable fields0
Avg. time to fill out4 min 45 sec
Other nameshow to give someone temporary custody of a child in az, temporary guardianship without court, guardianship forms arizona, az temporary guardianship

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GUARDIANSHIP

OF MINORS (only)

1

Temporary / Emergency Orders

for Guardianship of MINORS

(Forms and Instructions)

©Superior Court of Arizona in Maricopa County

ALL RIGHTS RESERVED

JGT1c - 5284 -

SELF-SERVICE CENTER

TEMPORARY / EMERGENCY APPOINTMENT OF GUARDIAN

FOR MINOR(S)

CHECKLIST

You may use the forms and instructions in this packet if . . .

You want to have the court appoint a guardian for one or more persons under the age of 18 on a temporary or emergency basis for a period of not more than 6 months.*

The minor lives in Maricopa County.

The person who will serve as guardian is not one of the parents.

You believe that the minor(s) needs to have a guardian temporarily and/or immediately.*

You are applying for Guardianship for more than one child, they have the same parents. **

*If the need for the guardianship will continue for more than 6 months, you will need to petition for “permanent” guardianship.

**If there are multiple children and they do not all have the same fathers and mothers, you must file a separate case for each set of parents.

READ ME: Consulting a lawyer before filing documents with the court may help prevent

unexpected results. A list of lawyers you may hire to advise you on handling your own case or to perform specific tasks, as well as a list of court-approved mediators can be found on the Self- Service Center website at:

www.superiorcourt.maricopa.gov/SSC

©Superior Court of Arizona in Maricopa County

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ALL RIGHTS RESERVED

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Self-Service Center

APPOINTMENT OF A TEMPORARY / EMERGENCY

GUARDIAN

FOR MINOR(S) ONLY

FORMS AND INSTRUCTIONS

This packet contains court forms and instructions to get a temporary or emergency guardianship for a minor (or minors). Forms that you will need to copy and file with the Court appear in BOLD below. Non-bold items are instruction or information pages. Do not file or copy non-bold items.

Order

File Number

Title

# pages

 

 

 

 

1

JGT1k

Checklist : You may use these forms if . . .

1

 

 

 

 

2

JGT1t

Table of Contents (this page)

1

 

 

 

 

3

JGT10h

How to Get a Guardian Appointed for a Minor on a Temporary /

4

Emergency Basis (Instructions and Helpful Information)

 

 

 

 

 

 

 

4

JG10f

“Juvenile Guardianship Information” Sheet

1

 

 

 

 

5

JGT11f

“Petition for Temporary Appointment of a Guardian for a

8

Minor”

 

 

 

 

 

 

 

6

JG11f

“Affidavit of Person to be Appointed Guardian”

3

 

 

 

 

The documents you have received are copyrighted by the Superior Court of Arizona in Maricopa County. You have permission to use them for any lawful purpose. These forms shall not be used to engage in the unauthorized practice of law. The Court assumes no responsibility and accepts no liability for actions taken by users of these documents, including reliance on their contents. The documents are under continual revision and are current only for the day they were received. It is strongly recommended that you verify on a regular basis that you have the most current documents.

©Superior Court of Arizona in Maricopa County

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ALL RIGHTS RESERVED

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SELF-SERVICE CENTER

HOW TO GET A GUARDIAN APPOINTED FOR A MINOR ON A

TEMPORARY and/or EMERGENCY BASIS

Introduction: These are the steps to ask the Court to appoint a temporary guardian for a minor. A temporary guardianship only lasts for a maximum of six (6) months unless extended by the Court or until the court hearing takes place on a request to appoint what the Court calls a “permanent” guardian. The temporary guardian and the permanent guardian may be the same person.

You may file for permanent and temporary guardianship together or separately.

You may file for permanent guardianship without filing for temporary.

You may file for temporary guardianship without filing for permanent if the guardian will not be needed for longer than six months.

Temporary Guardianship

The regular, “permanent” guardianship process takes about two months. It is appropriate to file for a temporary guardianship when there are good reasons you cannot wait the few months it would take to get a permanent appointment, or you do not expect a guardian will be needed for more than six months.

Temporary Emergency Guardianship Without Notice (sometimes called “ex parte”), is granted when a person needs a guardian appointed immediately, without prior notice to the parents of the minor or to other persons who have a legal right to know that a legal process has been started that involves the minor.

This is a very serious matter. The Judge will not grant a temporary appointment without notice unless you have a very good reason and can prove that immediate and irreparable injury, loss, or damage will result before notice can be given. A Temporary Emergency Guardianship appointment only lasts for a maximum of 30 days unless extended by the Court.

SECTION I: PREPARE THE DOCUMENTS

1.Complete the documents for the TEMPORARY APPOINTMENT.

Fill out all the forms for the temporary appointment completely:

USE BLACK INK.

COMPLETE the PETITION FOR TEMPORARY APPOINTMENT OF A GUARDIAN FOR A MINOR.

MAKE 2 COPIES of the completed forms.

2.If applicable: Complete the forms for the PERMANENT APPOINTMENT. (Separate

packet required). You need the following list of forms you need to start the case for the permanent appointment:

JUVENILE GUARDIANSHIP INFORMATION SHEET

PETITION FOR PERMANENT APPOINTMENT OF A GUARDIAN for a MINOR

AFFIDAVIT OF PERSON TO BE APPOINTED GUARDIAN. (Required by ARS §14-5106)

©Superior Court of Arizona in Maricopa County

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3. Photocopy all the documents: Make 2 copies of all the forms. Assemble the copies so that you have 3 complete packets -- the originals and 2 sets of copies.

4.File the papers at the court: Determine where to file the court forms. There are two facilities for the Maricopa County Juvenile Court:

Durango Facility

Southeast Facility

3131 W. Durango Street

1810 S. Lewis Street

Phoenix, AZ 85009

Mesa, AZ 85210

Cases are assigned to a facility based upon the zip code of the residence of the petitioner. If the zip code is 85200 through and including 85299, or any zip code area that is east of Central Avenue, the case will probably be assigned to the Southeast Facility. Any zip code that is west of Central Avenue will probably be assigned to the Durango Facility.

You can present your documents for filing at either location; however you are encouraged to take them to the correct facility for faster processing.

GO TO THE CLERK’S OFFICE: Take the original and 2 copies of the following documents to the Clerk of the Court (Juvenile):

JUVENILE GUARDIANSHIP INFORMATION SHEET

PETITION FOR TEMPORARY APPOINTMENT OF A GUARDIAN FOR A MINOR

(if applicable) PETITION FOR APPOINTMENT OF A PERMANENT GUARDIAN of a MINOR,

AND

AFFIDAVIT OF PERSON TO BE APPOINTED GUARDIAN

There is a fee for filing for guardianship, which must have been paid or deferred before filing these papers. If you have paid or deferred the fee to file one, there is currently no separate fee to file the other.

Note: If you will have difficulty paying the filing fee, you may apply for a fee deferral (payment plan) or waiver. Applications are available from the Self-Service Center or the Juvenile Court filing counter.

WHAT THE CLERK WILL DO: The Clerk will file the original JUVENILE GUARDIANSHIP

INFORMATION SHEET (This document is for court use only; it is not a public record). The Clerk will file originals of the following documents, and give you back clerk-stamped (“conformed”) copies to show these documents were filed:

PETITION FOR TEMPORARY APPOINTMENT OF GUARDIAN

(if applicable) PETITION FOR APPOINTMENT OF PERMANENT GUARDIAN OF A MINOR, AND

AFFIDAVIT OF PERSON TO BE APPOINTED GUARDIAN

NOTE YOUR “JG” CASE NUMBER: The case number assigned is stamped in the upper right-hand corner of all the documents the clerk stamped for you. The case number always starts with the initials ”JG”. Use this number on every paper you file with the court from now on.

5. (If applicable) Schedule the Permanent hearing date: Take originals of one or both of the following papers to Juvenile Court Administration:

INSTRUCTIONS AND REQUEST FOR HEARING DATE; AND

Take 2 copies of these Clerk-stamped (conformed) papers to Juvenile Court Administration:

PETITION FOR APPOINTMENT OF GUARDIAN FOR A MINOR,

AFFIDAVIT OF PERSON TO BE APPOINTED GUARDIAN

©Superior Court of Arizona in Maricopa County

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Juvenile Court Administration will, if applicable, schedule the permanent hearing on the form called INSTRUCTIONS AND REQUEST FOR HEARING DATE and return it to you. Now you know the date, time, and location of the hearing on the permanent appointment, and the name of the Judge or Commissioner who will hear the case.

6. To schedule the hearing on the Temporary or emergency appointment:

If you have requested that a temporary guardian be appointed, Juvenile Court Administration will take the Petition for Temporary Appointment of Guardian to the assigned Judicial Officer for review. The assigned Judicial Officer will set a hearing date ONLY if he/she agrees that an emergency exists.

If the Judge decides to give you a hearing on the petition for Temporary Appointment of a Guardian of a Minor, court staff will provide you with 2 copies of a NOTICE OF HEARING form. You will need to give notice of the hearing to everyone entitled to notice before the hearing. See #7, below, and Packet Part 2--Service and Notice of the Court Hearing, for information on who must be given notice.

7.LEGAL NOTICE: You must give notice about the court case: If this is an emergency hearing with notice, you must give notice to everyone required to be given notice under Arizona law of a petition for permanent guardianship, as required by Arizona law (A.R.S. §14-5310 and 14-5401). See Packet Part 2--Service and Notice of the Court Hearing. Notice must be complete before the hearing.

If this is an emergency hearing without notice, you must give notice to the person who needs the temporary or emergency guardianship by personal service within 72 hours after the Court hearing. No other notice is required in these cases.

SECTION 2: PREPARE for THE HEARING

8.Legal Notice Before the hearing: If you were required to give advance notice of the

temporary or emergency hearing, file the originals of the following documents: NOTICE OF HEARING, WAIVER OF NOTICE, (If applicable), and PROOF OF NOTICE.

Bring copies of all 3 documents with you to the hearing to be “conformed” (stamped by Court staff). Do this as soon as possible, at least 3 business days before the hearing on the temporary petition. Otherwise, bring these documents with you to the hearing.

9.Documents to bring to the hearing: Bring to the hearing the original documents, and any documents you filed with the Clerk, such as:

Proof of Notice of Hearing

Waiver of Notice, (if applicable)

Acceptance of Service (if applicable)

Affidavit Supporting Publication (if applicable)

10.Other information to know before the Court Hearing:

The Juvenile Court uses a digital audio recording system to preserve the official court record of the proceedings. If a party want a court reporter to record a proceeding in the Juvenile Court, they must file a written request with the Clerk of Court and Juvenile Court Administration at least

72 hours before the start of the guardianship proceeding.

©Superior Court of Arizona in Maricopa County

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ALL RIGHTS RESERVED

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If you need a court interpreter, telephone 602-506-0490 at least 10 days before the hearing.

Be prepared to testify at the Court hearing about why you think the Guardianship is needed. Bring with you to Court any witnesses you think will help you testify.

Tell the Judge about the case, and why the temporary appointment is necessary. Bring all paperwork with you that you think is applicable, such as reports about the person you say needs the guardian, police or Child Protective Services (CPS) records concerning the person, etc.

SECTION 3 – AFTER THE COURT HEARING

11.Go to the Court Clerk: Ask whether the Judge signed the Order, and when you can get a copy of it. After you receive the Order for Temporary Guardianship, you will need a certified copy to show you are the person officially appointed by the Judge. There is a $26.00 certification fee plus $0.50 per page to do this. Payment may be made in cash (in person only) or by check or money order made payable to the Clerk of Court.

If you did not already give legal notice about the PETITION FOR TEMPORARY APPOINTMENT and the court hearing as described in STEP 7, then you must now give notice of the court papers and the hearing to everyone who is entitled to know about the court case before the hearing date.

12.Other help: Court personnel can answer certain limited questions about the procedures involved, but only an attorney can give you legal advice. You can call the Maricopa County Bar Association’s Lawyer Referral Service at 602-257-4434 to schedule a half-hour consultation for $35, or find a lawyer in the yellow pages of your telephone book (or online) under “attorneys”.

The Self-Service Center also has a list of lawyers who will, for a fee, assist you on a task-by-task basis or advise you on how to conduct your own case. The list shows where the lawyers are located, how much they charge to look over the court papers or answer your questions, and what their experience is. You

may view the list at the Self Service Center or on the Court’s web site at:

www.superiorcourt.maricopa.gov/SuperiorCourt/Self-ServiceCenter/LawyersAndMediators/

©Superior Court of Arizona in Maricopa County

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ALL RIGHTS RESERVED

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Name of Person Filing Document: Address:

City, State, Zip Code:

Telephone Number:

Attorney Bar Number (if applicable): Representing Self or Attorney for

For Clerk’s Use Only

SUPERIOR COURT OF ARIZONA

IN MARICOPA COUNTY JUVENILE COURT

In the matter of Guardianship of:

A Minor

Female

Male

Case Number JG

JUVENILE GUARDIANSHIP INFORMATION SHEET

THIS FORM IS TO BE COMPLETED BY THE PETITIONER(S) AND RETURNED

TO THE CLERK AT THE TIME OF FILING THE PETITION.

This information is confidential and for Court use only, and is not part of the public record.

DESCRIPTION OF

 

PETITIONER

 

 

CO-PETITIONER

Name

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

City, State, Zip

 

 

 

 

 

 

 

Telephone Number

(

)

 

 

 

(

)

Date of Birth

 

 

 

 

 

 

 

Social Security Number

 

 

 

 

 

 

 

Passport Number

 

 

 

 

 

 

 

Ethnicity

 

 

 

 

 

 

 

Height

 

 

 

 

 

 

 

Weight

 

 

 

 

 

 

 

Color of Hair

 

 

 

 

 

 

 

Color of Eyes

 

 

 

 

 

 

 

Relationship to person(s)

 

 

 

 

 

 

 

to be protected

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Private Fiduciary Certification or Licensing Number:

 

 

 

 

 

 

 

 

 

Date of birth of Minor(s): (Month/Day/Year)

 

 

 

 

 

 

 

Is the person you are seeking to assist a foreign national?

Yes

No

If yes, please specify country:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Is the Minor(s) or a sibling of the Minor(s) involved in a Juvenile Dependency action?

Will you or any person required to receive notice need a court interpreter?

If “Yes”, what language(s) ?

YES

YES

NO

NO

© Superior Court of Arizona in Maricopa County

JG10f-071012

ALL RIGHTS RESERVED

 

Page 1 of 1

Name of Person Filing Document:

Address:

City, State, Zip Code:

Telephone Number:

Attorney Bar Number (if applicable):

Representing Self (Without a Lawyer OR Attorney for

FOR CLERK’S USE ONLY

SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY

In the Matter of Guardianship of:Case Number: JG

 

PETITION FOR

 

TEMPORARY APPOINTMENT

A Minor

OF A GUARDIAN FOR A MINOR

 

EMERGENCY APPOINTMENT

 

WITHOUT NOTICE REQUESTED

INFORMATION FROM GUARDIANS, UNDER OATH or AFFIRMATION:

1.INFORMATION ABOUT PETITIONER

Name:

Street Address:

City, State, Zip Code:

Telephone:Date of Birth:

I am related by blood to the children. Explain how you are related. (Examples: grandmother, uncle, sister, etc.)

Are you related to the children through the Mother’s side of the family or the Father’s side?

Mother

Father

Paternity has been established through

Birth Certificate

Court Order

I am NOT related by blood to the children. Explain how you know the children.

Note: If the person to be appointed Guardian is not related to the child, the person will need

to submit a full set of fingerprints to obtain a criminal background investigation.

©Superior Court of Arizona in Maricopa County

JGT11f 042313

ALL RIGHTS RESERVED

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PTT

Case No.

2.INFORMATION ABOUT THE CHILDREN WHO NEED A TEMPORARY

GUARDIAN:

(Make copies of this page if needed for additional children)

male female

a. Child’s name: Child’s birth date: Child’s birth place: Child’s address:

male female

b. Child’s name: Child’s birth date: Child’s birth place: Child’s address:

male

c. Child’s name: Child’s birth date: Child’s birth place: Child’s address:

female

male

female

d. Child’s name: Child’s birth date: Child’s birth place: Child’s address:

(If more than four children, please attach information for all children)

©Superior Court of Arizona in Maricopa County

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Case No.

3.The person or agency currently having legal custody, guardianship, acting in loco parentis (acting as parent) or providing care for the children is:

Name:

Address:

4.Reasons for Temporary Appointment. Explain why the temporary appointment of a guardian is necessary at this time:

5.Disability or Incapacitation. Are the Children disabled or incapacitated to the extent that he or she will need a guardian AFTER reaching the age of 18?

YES. The Children WILL need a guardian after reaching the age of 18.

NO. The Children WILL NOT need a guardian after reaching the age of 18.

6.A guardianship lasting more than 6 months:

Will be needed; or

Will not be needed

If a guardianship lasting more than 6 months is not needed, please explain why.

©Superior Court of Arizona in Maricopa County

JGT11f 042313

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Case No.

7.Information about person to be appointed guardian or any person who will serve

as a co-guardian (if different person than Petitioner)

Name:

Street Address:

City, State, Zip Code:

Telephone:

 

Date of Birth:

 

 

 

 

 

 

This person is related by blood to the children. Explain how they are related. (Examples: grandmother, uncle, sister, etc.)

Is this person related to the children through the Mother’s side of the family or the Father’s side?

Mother

Father

This person is NOT related by blood to the children. Explain how this person knows the children.

Note: If the person to be appointed Guardian is not related to the child, the person will need

to submit a full set of fingerprints to obtain a criminal background investigation.

8.Why should this Court choose the person you request to be the guardian?

9.Will anyone object or disagree with the Temporary Guardianship?

Mother of the children will object or disagree with you being temporary guardian because:

©Superior Court of Arizona in Maricopa County

JGT11f 042313

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Case No.

Father of the children will object or disagree with you being temporary guardian because:

Children (over age 14) will object or disagree with you being temporary guardian because:

If you feel a parent will not consent and the children are in danger, you can call

Child Protective Services at 1-888-SOS-CHILD (1-888-767-2445)

10.INFORMATION REGARDING GUARDIANSHIP: (Prior Appointment) To the best of my knowledge, (check one box):

No Guardian or Conservator has been appointed in any other court, and no court proceedings are pending for such appointment.

Someone has been appointed or court proceedings are pending (explain who, when, in what court, and if appointee, whether guardian or conservator, or both):

There is a dependency petition pending in any Court. (explain when, in what court, and list the case number):

Child Protective Services has been involved with the family. (explain when, in what State, and outcome):

11.Persons Entitled to Notice under Arizona law

Arizona law says that mother, father, children age 14 and over, current guardians, and other persons the children have recently been living with are entitled to Notice of the Petition for Guardianship or must consent or agree to a temporary guardianship. (Refer to Instructions and A.R.S. §§ 14-5207 and 14-5310 regarding who must be given Notice.)

A.

I will give Notice to the following persons: (if not, explain why in “B” and/or “C” and/or “D” and/or “E”, below)

©Superior Court of Arizona in Maricopa County

JGT11f 042313

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Case No.

Name

Address (Street Address, City, State, Zip)

Children, if age 14 and over

Attorney for Children (if already appointed)

Mother of Children

Father of

Children

Current Guardian

Relationship to children, if any

Person with whom the children recently has been living

Other:

Relationship to children, if any

B.

I have notarized, signed consents for the following person(s):

C.

I should NOT be required to give notice prior to the court hearing to all persons required by law, because: (Explain why advance notice about this court case has not been given to any party entitled to notice.)

©Superior Court of Arizona in Maricopa County

JGT11f 042313

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D.

Case No.

Temporary Guardianship without prior notice is needed because:

(There is an emergency situation that requires appointment of a temporary guardian immediately and without prior notice to persons entitled to notice under Arizona law. (Explain in detail.)

E.

THE CHILD OR CHILDREN WILL BE HARMED IF THE TEMPORARY GUARDIANSHIP IS NOT GRANTED WITHOUT PRIOR NOTICE. (Explain in detail.)

IF THE COURT APPOINTS A TEMPORARY GUARDIAN WITHOUT NOTICE HAVING BEEN GIVEN TO ANY PERSON ENTITLED TO NOTICE, you will be required to give notice by personal service to all persons required by law, no later than 72 hours after the Judge signs the Temporary Order.

©Superior Court of Arizona in Maricopa County

JGT11f 042313

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Case No.

REQUESTS TO THE COURT:

1. Find that the Child or Children about whom this petition is filed is/are in need of a temporary guardian.

2.(Check this box only if you are asking for an emergency appointment without notice, and have completed question 13 (C), (D) or (E).)

Find that an emergency exists and this temporary order is necessary without notice to the Children or to other persons legally entitled to notice.

3.Appoint the person identified in this petition as the temporary guardian for the Children until a court hearing can take place on this matter, or until further order of the Court.

OATH OR AFFIRMATION AND VERIFICATION OF PETITIONER

I state to the Court, under penalty of perjury, that I have read this petition and all the statements in the petition are true and correct and complete to the best of my knowledge and belief.

Petitioner’s Signature

Signed and sworn to or affirmed before me this date:

 

 

by:

 

 

 

 

 

OR

Michael K. Jeanes, Clerk of Superior Court

Notary

 

 

 

 

My commission expires:

 

By:

 

 

(or Seal, below)

 

 

 

Deputy Clerk

I state to the Court, under penalty of perjury, that I have read this petition and all the statements in the petition are true and correct and complete to the best of my knowledge and belief.

Petitioner’s Signature

Signed and sworn to or affirmed before me this date:by:

 

 

 

OR Michael K. Jeanes, Clerk of Superior Court

Notary

 

 

 

My commission expires:

 

By:

(or Seal, below)

 

 

 

Deputy Clerk

©Superior Court of Arizona in Maricopa County

 

 

JGT11f 042313

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Name of Person Filing Document:

Your Address:

Your City, State, Zip Code:

Your Telephone Number:

Attorney Bar Number (if applicable):

Representing Self (Without a Lawyer) OR Attorney for:

For Clerk’s Use Only

SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY

In the Matter of the Guardianship of:Case Number: JG

 

AFFIDAVIT OF PERSON

____________________________

TO BE APPOINTED GUARDIAN

a Minor

 

INSTRUCTIONS: The person who wants to be appointed the guardian must answer each statement as

TRUE or FALSE. Each answer that is false must be explained in writing in an attachment to this affidavit.

STATEMENTS MADE UNDER OATH OR AFFIRMATION TO THE COURT: Arizona

law A.R.S. §14-5106 requires the person seeking appointment to answer items 1-11. This document must be filed with the “Petition for Permanent (or Temporary) Appointment of Guardian for a Minor”.

The nature of my relationship to the Minor is: (Example: grandparent/sister/uncle)

I met the Minor under the following circumstances:

1.

2.

3.

4.

5.

6.

7.

.

True or

False.

I have not been convicted of a felony in any jurisdiction.

True or

False.

I have not acted as a guardian for another person for at least three years before I

 

 

filed this Petition.

True or

False.

I know and understand the powers and duties I would have as a guardian.

True or

False.

I have not had a power of attorney for anyone for at least three years before I filed

 

 

this Petition.

True or

False

Arizona law requires that a guardian file an annual report with the Court. If I have

Does Not Apply.

been a guardian before, I either filed the required documents on time, or within 3

 

 

months of receiving a notice from the court that the report was due.

True or

False.

I have never been removed as a guardian or conservator by the Court.

True or

False.

I have never received anything of value greater than a total of one hundred dollars in

 

 

any one year by gift, or will, or inheritance from an individual or the estate of an

 

 

individual to whom I was not related by blood or marriage and for whom I served at

 

 

any time as guardian, conservator, trustee, or attorney-in-fact

©Superior Court of Arizona in Maricopa County

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AFF

8.

9.

10.

11.

12.

 

 

Case No. JG

 

 

True or

False.

No business in which I have an interest has ever received anything of value greater

 

 

than a total of one hundred dollars in any one year by gift, or will, or inheritance from

 

 

an individual or the estate of an individual to whom I am not related by blood or

 

 

marriage and for whom I served at any time as guardian, conservator, trustee, or

 

 

attorney-in-fact.

True or

False.

To the best of my knowledge, I am not named as a personal representative, trustee,

 

 

beneficiary, or other type of beneficiary for any individual to whom I am not related by

 

 

blood or marriage and for whom I have ever served as guardian, conservator,

 

 

trustee, or attorney-in-fact.

True or

False.

To the best of my knowledge, no business in which I have an interest is named as a

 

 

personal representative, trustee, beneficiary, or other type of beneficiary for any

 

 

individual to whom I am not related by blood or marriage and for whom I have ever

 

 

served as guardian, conservator, trustee, or attorney-in-fact.

True or

False.

I have no interest in any business that provides housing, health care, nursing care,

 

 

residential care, assisted living, home health services, or comfort care services to

 

 

any individual.

True or

False.

I have never been charged with or convicted of any kind of abuse, neglect or

 

 

mistreatment of a child or an elderly person. I am not named on any Registry of this

 

 

State or any other of Sex Offenders or persons who have committed acts of abuse,

 

 

violence or neglect against children or elderly persons. (If you checked “False”, be

 

 

prepared to explain the circumstances and why the Court should appoint you as a

 

 

guardian in this case.)

OATH OR AFFIRMATION OF THE PERSON SEEKING TO BE APPOINTED GUARDIAN

I have read this document. The information contained in this document is true, correct, and complete to the best of my belief and knowledge.

 

 

Signature of Person to be Appointed Guardian

Signed, sworn to or affirmed before me this date:

 

 

 

 

 

 

 

 

 

 

 

Michael K. Jeanes, Clerk of Superior Court

Notary

 

 

 

 

 

OR

My commission expires:

By:

 

 

 

Deputy Clerk of Court

NOTE: IF YOU ANSWERED “FALSE” TO ANY QUESTION ABOVE, YOU MUST ATTACH AN

EXPLANATION AS INSTRUCTED ON THE NEXT PAGE.

The page following is an instruction page only. Do not file it with the Court.

©Superior Court of Arizona in Maricopa County

Page 2 of 3

JG11f-092011

ALL RIGHTS RESERVED

 

 

AFF

DO NOT FILE THIS SHEET
WITH THE CLERK’S OFFICE INSTRUCTION SHEET ONLY

Case No. JG

EXPLANATIONS THAT MUST BE ADDED TO THE AFFIDAVIT OF PERSON WHO WANTS TO BE

APPOINTED (Required by Arizona Law: A.R.S. § 14-5106)

You must explain the following as an attachment to your Affidavit for any statement which you marked "F" (false). FILE THE EXPLANATIONS WITH THE AFFIDAVIT, BUT DO NOT FILE THIS INSTRUCTION SHEET. All the information in the explanations is also under oath to the court.

1. As to each felony for which you have been convicted, list:

a. The nature of the offense.

b.The name and address of the sentencing court.

c. The case number.

d.The date of conviction.

e.The terms of the sentence.

f.The name and telephone number of any current probation or parole officer.

g.The reasons why the conviction should not disqualify you from appointment.

2.If you have acted as guardian or conservator within three years before filing this petition, list:

a.The names of individuals for whom you are currently serving, and court case numbers.

b.The names of individuals for whom your appointment has been terminated within the three-year period, and the court case number.

3.If you do not have the required information, please explain how you intend to obtain this information.

4.State the total number of persons for whom you have done this. If you have acted under a power of attorney for the Minor/protected person, explain:

a.The date the power of attorney was signed.

b.The place where it was signed.

c.The actions you have taken pursuant to the power of attorney.

d.Whether the power of attorney is currently in effect.

5.List the name and location of the court and the name and case number of the files in which you were delinquent in filing the required report.

6.List the name and location of the court, the name and case number of each file, and the circumstances of your removal.

7.State the number of occasions on which you received such gifts, list the gifts, the dates they were received, describe the gifts and list the value of each.

8.State the number of occasions on which the business received such gifts, list the gifts, the dates they were received, describe the gifts and list the value of each.

9.State the number of occasions on which you have been so named.

10.State the number of occasions on which the business was named.

11.List the name and address of each business and the extent and nature of your interest.

12.Explain in detail the circumstances of any charge or conviction for abuse or neglect of children or the elderly (not already covered in (1) above), and /or of your name being listed on any registry of sex offenders or persons who have committed acts of abuse, violence or neglect against children or elderly persons. Include date(s), location(s), name(s) of any investigating agencies and of any courts involved, as well as the title of any registry on which you are named and explain the circumstances that resulted in your being listed there. Explain why this court should appoint you as guardian despite any of these circumstances.

©Superior Court of Arizona in Maricopa County

Page 3 of 3

JG11f-092011

ALL RIGHTS RESERVED

 

 

AFF

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